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Interactions

Digoxin/Calcium Channel Blockers

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may not process digoxin properly.

What might happen:

The blood levels of digoxin may increase and cause toxic effects.

What you should do about this interaction:

If you experience nausea, vomiting, diarrhea, loss of appetite, slow or irregular heartbeat, or vision changes (e.g. blurred vision or yellow/ green halos around objects), contact your doctor. You may need to have your blood level of digoxin checked, and your dose may need to be adjusted.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this drug interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Belz GG, Wistuba S, Matthews JH. Digoxin and bepridil: pharmacokinetic and pharmacodynamic interactions. Clin Pharmacol Ther 1986 Jan;39(1):65-71.

2.Kuhlmann J. Effects of nifedipine and diltiazem on plasma levels and renal excretion of beta-acetyldigoxin. Clin Pharmacol Ther 1985 Feb;37(2):150-6.

3.Oyama Y, Fujii S, Kanda K, Akino E, Kawasaki H, Nagata M, Goto K. Digoxin-diltiazem interaction. Am J Cardiol 1984 May 15;53(10):1480-1.

4.Rameis H, Magometschnigg D, Ganzinger U. The diltiazem-digoxin interaction. Clin Pharmacol Ther 1984 Aug;36(2):183-9.

5.Andrejak M, Hary L, Andrejak MT, Lesbre JP. Diltiazem increases steady state digoxin serum levels in patients with cardiac disease. J Clin Pharmacol 1987 Dec;27(12):967-70.

6.North DS, Mattern AL, Hiser WW. The influence of diltiazem hydrochloride on trough serum digoxin concentrations. Drug Intell Clin Pharm 1986 Jun; 20(6):500-3.

7.Beltrami TR, May JJ, Bertino JS Jr. Lack of effects of diltiazem on digoxin pharmacokinetics. J Clin Pharmacol 1985 Jul-Aug;25(5):390-2.

8.Elkayam U, Parikh K, Torkan B, Weber L, Cohen JL, Rahimtoola SH. Effect of diltiazem on renal clearance and serum concentration of digoxin in patients with cardiac disease. Am J Cardiol 1985 May 1;55(11):1393-5.

9.Young PM, Boden WE, More G. Lack of effect of high dose diltiazem on serum digoxin levels. Clin Pharmacol Ther 1985;37(2):239.

10.Schrager BR, Pina I, Frangi M, Applewhite S, Sequeira R, Chahine RA. Diltiazem, digoxin interaction?. Circulation 1983 Oct;68(Suppl III):III-368.

11.Jones WN, Kern KB, Rindone JP, Mayersohn M, Bliss M, Goldman S. Digoxin-diltiazem interaction: a pharmacokinetic evaluation. Eur J Clin Pharmacol 1986;31(3):351-3.

12.Boden WE, More G, Sharma S, Bough EW, Korr KS, Young PM, Shulman RS. No increase in serum digoxin concentration with high-dose diltiazem. Am J Med 1986 Sep;81(3):425-8.

13.Johnson BF, Wilson J, Marwaha R, Hoch K, Johnson J. The comparative effects of verapamil and a new dihydropyridine calcium channel blocker on digoxin pharmacokinetics. Clin Pharmacol Ther 1987 Jul;42(1):66-71.

14.Rodin SM, Johnson BF, Wilson J, Ritchie P, Johnson J. Comparative effects of verapamil and isradipine on steady-state digoxin kinetics. Clin Pharmacol Ther 1988 Jun;43(6):668-72.

15.Rehnqvist N, Billing E, Moberg L, Lundman T, Olsson G. Pharmacokinetics of felodipine and effect on digoxin plasma levels in patients with heart failure. Drugs 1987;34 Suppl 3:33-42.

16.Dunselman PH, Scaf AH, Kuntze CE, Lie KI, Wesseling H. Digoxin-felodipine interaction in patients with congestive heart failure. Eur J Clin Pharmacol 1988;35(5):461-5.

17.Debruyne D, Commeau P, Grollier G, Huret B, Scanu P, Moulin M. Nicardipine does not significantly affect serum digoxin concentrations at the steady state of patients with congestive heart failure. Int J Clin Pharmacol Res 1989;9(1):15-9.

18.Lessem J, Bellinetto A. Interaction between digoxin and the calcium antagonists nicardipine and tiapamil. Clin Ther 1983;5(6):595-602.

19.Kirch W, Stenzel J, Dylewicz P, Hutt HJ, Santos SR, Ohnhaus EE. Influence of nisoldipine on haemodynamic effects and plasma levels of digoxin. Br J Clin Pharmacol 1986 Aug;22(2):155-9.

20.Lanoxin (digoxin) Tablets US prescribing information. GlaxoSmithKline August, 2012.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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